ESC Heart Failure最新文献

{"title":"Neutrophil-to-lymphocyte ratio: link to congestion, inflammation, and mortality in outpatients with heart failure.","authors":"Asma O M Rezig, Moustafa I Morsy, Elisabetta Caiazzo, Antonio Iaconelli, Armando Ialenti, David Hunter, Joe J Cuthbert, Syed Kazmi, Tomasz J Guzik, Dario Bruzzese, John G F Cleland, Andrew L Clark, Pasquale Maffia, Pierpaolo Pellicori","doi":"10.1002/ehf2.15240","DOIUrl":"https://doi.org/10.1002/ehf2.15240","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-to-lymphocyte ratio (NLR) may be a useful marker of inflammation, but its associations with clinical characteristics, signs of congestion and outcome in patients with chronic heart failure (HF) are unknown.</p><p><strong>Methods and results: </strong>We enrolled 4702 ambulatory patients with HF and either left ventricular systolic dysfunction or high N-terminal pro-B-type natriuretic peptide (NTproBNP) (≥125 ng/L). Compared with those in the lowest quartile of NLR (≤2.05), patients in the highest quartile (≥4.10) were older, had higher NTproBNP, and were more likely to have HF with reduced left ventricular ejection fraction (HFrEF), atrial fibrillation and to be treated with loop diuretics. In 813 patients with detailed echocardiographic assessment, lymphocyte count correlated inversely with NTproBNP (r = -0.31) and markers of congestion [left atrial volume index (r = -0.25), inferior vena cava diameter (r = -0.24)]; neutrophil count correlated positively with high-sensitivity C-reactive protein (hsCRP) (r = 0.31, P < 0.001). During a median follow-up of 54 (29-100) months, 3015 (64%) patients died. In models adjusted for NTproBNP and HsCRP, higher NLR [hazard ratio (HR):1.05; 95% confidence interval (CI) 1.03-1.06] and neutrophil count (HR:1.07; 95%CI 1.04-1.10) were associated with higher mortality rates; higher lymphocyte count (HR:0.88; 95%CI 0.82-0.95) was associated with lower risk (all P < 0.001).</p><p><strong>Conclusions: </strong>Low lymphocyte count is associated with more congestion and high neutrophil count with more inflammation, which may explain why a greater NLR is associated with a poorer prognosis. For patients with heart failure, NLR or its components could be useful for risk stratification or for monitoring evolving risk, but might also be therapeutic targets.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased endogenous nitric oxide production in acute decompensated heart failure with a reduced ejection fraction.","authors":"Roman Falls, Bing H Wang, Sara Vogrin, Christopher J Neil","doi":"10.1002/ehf2.15253","DOIUrl":"https://doi.org/10.1002/ehf2.15253","url":null,"abstract":"<p><strong>Aims: </strong>Heart failure represents a substantial burden to both patients and healthcare systems worldwide. Nitric oxide (NO) dysregulation may play a key role in patients transitioning from chronic to acute heart failure with a reduced ejection fraction (HFrEF). Plasma nitrite (NO₂ ^-) is highly reflective of local nitric oxide production and has not been studied in acute HFrEF. This study aims to quantify measures of NO biology in patients with acute and chronic HFrEF.</p><p><strong>Methods and results: </strong>We utilized gas-phase chemiluminescence to determine plasma NO₂ ^- concentrations. Plasma asymmetric dimethylarginine (ADMA) and arterial stiffness were also measured. Plasma concentrations of NO₂ ^- and ADMA, in addition to arterial stiffness, were compared in participants with chronic HFrEF (n = 25) and acute HFrEF (n = 24). We observed lower concentrations of plasma NO₂ ^- in patients with acute HFrEF (P = 0.047). We also observed higher plasma concentrations of ADMA in participants with acute HFrEF (P < 0.001). Plasma NO₂ ^- and ADMA also displayed a significant negative correlation in the total cohort (R_s = -0.38, P = 0.017). There was no significant difference between groups regarding arterial stiffness measures.</p><p><strong>Conclusions: </strong>We present novel data with regard to plasma NO₂ ^- in both acute and chronic HFrEF. Our results indicate that patients with acute HFrEF have a relative deficiency of plasma NO₂ ^- whilst also displaying a relative increase in ADMA, a modulator of eNOS. Reduced NO bioavailability may therefore relate to impaired NO production in patients with acute decompensation, with implications for both treatment and prevention of episodes.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"H₂FPEF and HFA-PEFF scores for heart failure risk stratification in hypertrophic cardiomyopathy patients.","authors":"Yi-Peng Gao, Hong-Yun Liu, Xiao-Jun Bi, Jie Sun, Ying Zhu, Wei Zhou, Ya-Ting Fan, Xue-Qing Cheng, Pei-Na Huang, Ya-Ni Liu, You-Bin Deng","doi":"10.1002/ehf2.15247","DOIUrl":"https://doi.org/10.1002/ehf2.15247","url":null,"abstract":"<p><strong>Aims: </strong>H₂FPEF and HFA-PEFF scores have demonstrated prognostic value in heart failure (HF) with preserved ejection fraction. This study aimed to explore the value of the H₂FPEF and HFA-PEFF scores for HF risk stratification in patients with hypertrophic cardiomyopathy (HCM).</p><p><strong>Methods and results: </strong>In this cohort study, 1068 HCM patients were included. Then the H₂FPEF and HFA-PEFF scores were calculated to categorize patients into low, intermediate, and high score groups. The primary endpoint was a composite of the first HF hospitalization and all-cause death. 594 (55.6%) patients were classified discordantly. After a follow-up period of 3.1 ± 2.1 years, 85 (8.0%) patients were admitted for HF for the first time, and 62 (5.8%) patients died. Rates of first HF hospitalization and all-cause death per 1000 person-years for the low, intermediate, and high H₂FPEF score groups were 25.0 (95% confidence interval [CI]: 14.5-35.4), 52.0 (95% CI: 41.6-62.3), and 148.1 (95% CI: 77.7-218.5), respectively. For the low-intermediate and high HFA-PEFF score groups, rates were 19.3 (95% CI: 11.6-27.0) and 69.3 (95% CI: 56.4-82.1), respectively. Intermediate H₂FPEF score (hazard ratio [HR]: 1.820, 95% CI: 1.135-2.919; P = 0.013), high H₂FPEF score (HR: 3.464, 95% CI: 1.774-6.765; P < 0.001), and high HFA-PEFF score (HR: 2.414, 95% CI: 1.501-3.882; P < 0.001) were each independently associated with an increased risk of the primary endpoint. Intermediate-high H₂FPEF score demonstrated an equal risk for the primary endpoint compared to the high HFA-PEFF score (HR: 0.826, 95% CI: 0.636-1.072; P > 0.05). Obesity (HR: 1.958, 95% CI: 1.140-3.363; P = 0.015), atrial fibrillation (HR: 1.686, 95% CI: 1.071-2.654; P = 0.024), pulmonary hypertension (HR: 1.613, 95% CI: 1.032-2.521; P = 0.036) of the H₂FPEF score, and the morphological major criterion (HR: 1.601, 95% CI: 1.084-2.364; P = 0.018) and functional major criterion (HR: 2.340, 95% CI: 1.442-3.797; P < 0.001) of the HFA-PEFF score were independent predictors of the primary endpoint. A new algorithm was constructed using the independent predictors from both scores, with the functional major criterion weighted as 2 points and the others as 1 point. The H₂FPEF score, HFA-PEFF score, and the new algorithm demonstrated C-indices of 0.594, 0.651, and 0.681, respectively.</p><p><strong>Conclusions: </strong>There is discordance in the classification of patients with HCM using the H₂FPEF and HFA-PEFF scores. Both scores demonstrated prognostic value in risk stratification for HF hospitalization and all-cause death in HCM patients. Future studies should develop and validate a new algorithm integrating both scores.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-related pathophysiological mechanisms may be present before symptoms of HFpEF develop.","authors":"B Wong, J Dodd, J Gallagher, B Dyer, C Ryan, K McDonald, M Ledwidge","doi":"10.1002/ehf2.15228","DOIUrl":"https://doi.org/10.1002/ehf2.15228","url":null,"abstract":"<p><strong>Aims: </strong>Understanding sex-related cardiovascular differences in those with pre-HFpEF (asymptomatic with normal ejection fraction, elevated natriuretic peptides and structural or functional heart disease) could help explain why females are more likely to develop symptomatic HFpEF compared with males. This study analyses sex-related cardiovascular differences in pre-HFpEF, including measures of cardiovascular stiffness and vascular resistance derived from cardiac magnetic resonance imaging (CMR) and Doppler echocardiography.</p><p><strong>Methods and results: </strong>This post hoc analysis of the PARABLE trial enrolled 250 patients with pre-HFpEF. CMR and Doppler echocardiography were used to estimate baseline markers of cardiovascular stiffness and resistance, including effective arterial elastance (EAE), systemic vascular resistance (SVR), total arterial compliance (TAC), left ventricular end diastolic pressure (LVEDP) and left ventricular end diastolic chamber stiffness index (LVSId). The population median age was 72.0 [IQR 68.0; 77.0] years and 38.4% were female. Both sexes had a similar age, blood pressure, HbA1c, renal function and H2FPEF score. Fewer female participants had a diagnosis of diabetes and coronary artery disease. When adjusted for age, hypertension, diabetes, obesity and vascular disease, female participants had higher pulse pressures (62.1 (SD 15.3) vs. 60.1 (SD 12.5) mmHg, P < 0.001) as well as higher median [IQR] levels of LDL-cholesterol (2.50 [2.10; 3.25] vs. 2.00 [1.60; 2.40] mmol/L, P < 0.001), EAE (1.55 [1.26; 1.84] vs. 1.26 [1.05; 1.51] mmHg/mL/m², P < 0.001), SVR (1609 [1288; 1887] vs. 1336 [1132; 1734] mmHg/mL/min², P = 0.001), LVEDP (18.5 [17.2; 20.1] vs. 18.0 [16.9; 19.3] mmHg, P < 0.001) and LVSId (0.28 [0.24; 0.31] vs 0.24 [0.20; 0.29] mmHg/mL/m², P < 0.001) than males. Females had higher median [IQR] NT-proBNP (176 [95.8; 286] vs. 127 [81.5; 242] pg/mL, P < 0.001) and lower median [IQR] TAC (1.24 [0.99; 1.58] vs. 1.55 [1.18; 1.91] mL/mmHg, P < 0.001) than male participants.</p><p><strong>Conclusions: </strong>Markers of elevated cardiovascular stiffness and vascular resistance are seen in female versus male participants with pre-HFpEF, suggesting that sex-related pathophysiological mechanisms are present before symptoms of HF develop.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise modalities on physical function and quality of life in patients with heart failure: A systematic review and network meta-analysis.","authors":"Jiang-Ying Li, Lu Chen, Qiu-Chen Wang, Jian Zhu, Zhen-Qing Ren, Li-Chun Wang","doi":"10.1002/ehf2.15256","DOIUrl":"https://doi.org/10.1002/ehf2.15256","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to evaluate the effects of various exercise modalities on physical function and quality of life in individuals with heart failure and to identify the most effective approaches.</p><p><strong>Methods and results: </strong>A network meta-analysis was conducted by searching PubMed, Embase and the Cochrane Library databases. Random-effects meta-analyses were performed to estimate mean differences (MD) and 95% confidence intervals (CI). A total of 60 randomized controlled trials, comprising 3261 participants, were included in the analysis. Yoga was associated with the greatest improvement in left ventricular ejection fraction (P-score = 0.91, MD: 0.90; 95% CI: 0.42 to 1.38) and the most significant reduction in serum natriuretic peptide levels (P-score = 0.965, MD: -1.46; 95% CI: -1.88 to -1.04). Interval training demonstrated superior effectiveness in increasing the 6-min walk distance (6MWD) (P-score = 0.873, MD: 113.01; 95% CI: 28.55 to 197.47). Combined aerobic and resistance training (AT + RT) showed the greatest benefits in enhancing peak oxygen uptake (VO_2peak) (P-score = 0.829, MD: 3.68; 95% CI: 2.23 to 5.13). High-intensity interval training combined with inspiratory muscle training (HIIT + IMT) yielded the most significant improvements in quality of life (P-score = 0.871, MD: -19.28; 95% CI: -26.42 to -12.14) and the greatest reduction in dyspnea (P-score = 0.804, MD: -1.58; 95% CI: -2.64 to -0.52).</p><p><strong>Conclusions: </strong>Current evidence suggests that yoga, interval training, AT + RT, and HIIT + IMT significantly enhance physical function and quality of life in individuals with heart failure, with each modality exhibiting distinct advantages. Further high-quality studies are warranted to confirm these findings and refine exercise prescriptions for this population.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility and safety of finerenone in patients with heart failure: Rationale and design of FINE registry.","authors":"Gonzalo Luis Alonso Salinas, Amaia Martínez León, Diego Aguiar Cano, Alberto Esteban-Fernández, José María Viéitez Flórez, Susana Del Prado Díaz, Juan Górriz-Magaña, Gregorio de Lara Delgado, Rafael González-Manzanares, Pedro Caravaca-Pérez, Francisco J Pastor-Pérez, Sandra Valdivieso-Moré, Juan Quiles, Inés Ponz, Vanessa Escolar, Edison Omar Boada Lincango, Néstor Báez-Ferrer, Gonzalo Gallego, Luis Almenar, Luis Gutiérrez de la Varga, Pau Codina, Alejandro Recio Mayoral, Aleix Fort, María Jesús Pinilla Lozano, David González-Calle, Inés Gómez-Otero, Cristina Salazar Mosteiro, Marta Cobo, Jesús Piqueras-Flores, Clara Bonanad, Ana Huerta, Maria Ferré Vallverdú, Pablo Díez-Villanueva","doi":"10.1002/ehf2.15260","DOIUrl":"https://doi.org/10.1002/ehf2.15260","url":null,"abstract":"<p><strong>Aims: </strong>Information about current use of finerenone in patients with heart failure (HF) finerenone in clinical practice is scarce, and its effectiveness in clinical practice in patients is scarce. We aim to assess both the baseline clinical profile and prognostic role of finerenone in patients with HF, irrespective of ejection fraction.</p><p><strong>Methods and results: </strong>The study is a multicentre, observational registry, including regional and tertiary hospitals. The registry incorporates contributions from cardiology, internal medicine, and nephrology departments, ensuring comprehensive data collection. Patients with previous history of decompensated HF and elevated natriuretic peptides (NPs) will be included and classified into two groups: Those initiating finerenone will constitute the study cohort, with a 1:1 matched control cohort including those patients not receiving finerenone. Follow-up will occur at 6 and 12 months (and optional 3 and 5 years). Endpoints will include the incidence of HF exacerbations requiring intravenous therapy, hospitalizations, renal replacement therapy, and mortality due to cardiovascular or renal causes.</p><p><strong>Conclusions: </strong>This study will provide valuable real-world evidence on the clinical effectiveness and safety of finerenone across a wide range of HF patients, including those with reduced, mildly reduced, and preserved ejection fraction. By leveraging a large, representative, and controlled cohort, the findings aim to enhance clinical decision-making and optimize the use of finerenone in routine practice, particularly in high-risk patients with complex co-morbidities.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of electrical storm patients listed for urgent heart transplantation but not transplanted acutely.","authors":"Miloud Cherbi, Philippe Maury, Léa Benabou, Maxime Faure, Matteo Pozzi, Laurent Sebbag, Estelle Gandjbakhch, Karim Benali, Pierre Groussin, Redwane Rakza, Raphael P Martins, Clément Delmas","doi":"10.1002/ehf2.15122","DOIUrl":"https://doi.org/10.1002/ehf2.15122","url":null,"abstract":"<p><strong>Aims: </strong>Refractory electrical storm (ES) is a life-threatening condition in which heart transplantation (HTx) can be proposed. Nevertheless, the shortage of donors and subsequent outcomes question its place as a rescue strategy. We aim to describe the prognosis of ES patients listed for HTx but not transplanted.</p><p><strong>Methods and results: </strong>Patients registered on urgent HTx waiting list for refractory ES without being transplanted during initial hospitalization were retrospectively included in five French centres from 2010 to 2022. The primary endpoint was 1-year all-cause mortality. Forty patients were included [90% men; 56.5 (50.0-61.3) years old; 63.6% and 24.2% dilated and ischaemic cardiomyopathies]. Among them, 84.6% received amiodarone, 64.1% received beta-blockers; 50.0% required deep sedation, 35.0% mechanical circulatory support, 10.0% stellate ganglion block; and 57.5% underwent catheter ablation. At 1 year, 20 patients (50.0%) died, including 14 in-hospital deaths (35.0%). Within six patients who died post-discharge, four previously underwent HTx, and one received VAD implantation. Twenty patients (50.0%) were still alive at 1 year: 10 underwent HTx, 1 received VAD implantation followed by subsequent HTx, while another underwent VAD implantation as destination therapy. Finally, five (12.5%) were removed from the HTx waiting list due to functional improvement, distinguished by a median LVEF of 45.0% (20.0%-45.0%). The remaining three patients (7.5%) were still registered on HTx waiting list.</p><p><strong>Conclusions: </strong>Refractory ES is a critical condition with high short- and long-term mortality. While HTx serves as a rescue strategy, rhythm management can sometimes overcome the critical phase, facilitating subsequent HTx under more favourable conditions or even allowing removal from the HTx waiting list.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary sclerosing cholangitis in patients suffering cardiogenic shock.","authors":"Hugo Lanz, Clemens Scherer, Philipp Kasper, Christoph Adler, Leonhard Binzenhöfer, Sabine Hoffmann, Julia Höpler, Marie Kraft, Nils Gade, Raúl Nicolás Jamin, Ruben Evertz, Daniel Hoyer, Jörn Tongers, Christian Schulze, Christian Jung, Julia Claus, Janine Pöss, Lisa Crusius, Norman Mangner, Christian Hagl, Georg Nickenig, Sebastian Zimmer, Steffen Massberg, Holger Thiele, Franz Haertel, Enzo Lüsebrink","doi":"10.1002/ehf2.15248","DOIUrl":"https://doi.org/10.1002/ehf2.15248","url":null,"abstract":"<p><strong>Aims: </strong>Cardiogenic shock (CS) patients suffer from severe organ hypoperfusion, yet the incidence of secondary sclerosing cholangitis in critically ill patients (SSC-CIP) in CS is poorly described. Given the limited evidence and severity of this syndrome, we aimed to further investigate SSC-CIP in the context of CS.</p><p><strong>Methods and results: </strong>24 251 total CS patients admitted between 1 January 2010 and 31 December 2023 were retrospectively screened for the diagnosis of SSC-CIP across nine German tertiary care centers. Following identification of confirmed SSC-CIP diagnosis, baseline characteristics, laboratory values, SSC-CIP-specific imaging, diagnostics, and outcomes were obtained for analysis. 35 CS patients with a diagnosis of SSC-CIP were identified, representing a prevalence of 0.14% [95% confidence interval (CI) 0.10, 0.19]. Patients were predominantly male (77.1%) with a median age of 58 years (interquartile range [IQR] 52.5, 68.0). Acute myocardial infarction (42.9%) was the most common aetiology of CS, followed by cardiac arrhythmias (20.0%). Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 77.1% of cases after a median of 33 days following CS onset [IQR 24, 65], showing typical biliary casts (60.0%), intraductal filling defects (28.6%), and bile duct obliteration (20.0%). Cast removal and stent placement was performed in nearly half of ERCP procedures (45.7%). Magnetic resonance cholangiopancreatography (MRCP) was performed in 22.9% of cases and showed intraductal dilation (11.4%), lumen narrowing (17.1%), or strictures (14.3%). Median intensive care unit and hospital length of stay was 43 days [IQR 33, 66] and 58 days [IQR 33, 88], respectively. In-hospital mortality was 57.1%. One-year (65.7%) and 3-year (71.4%) mortality remained high. Two patients underwent liver transplantation after a median of 113 days [IQR 105, 122] and were alive at 3-year follow-up.</p><p><strong>Conclusions: </strong>In this multicentre retrospective analysis in a high-risk CS cohort, SSC-CIP was a rare yet serious complication of intensive care unit stay with high in-hospital mortality. Treatment options are limited, and liver transplantation remains the only viable long-term treatment option.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In heart failure, echocardiographic parameters of right ventricular function are powerful tools to predict renal failure.","authors":"Alexander Reinecke, Paulina Dißmann, Norbert Frey, Oliver J Müller, Hatim Seoudy, Johanne Frank, Derk Frank, Martina E Spehlmann","doi":"10.1002/ehf2.15176","DOIUrl":"https://doi.org/10.1002/ehf2.15176","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) has a high prevalence in patients with heart failure (HF) and is associated with prolonged hospitalization, increased need for intensive care and mortality. There is an urgent need to identify factors that influence the interaction between heart and kidney disorders, often described as cardiorenal syndrome (CRS). We investigated the epidemiology and risk factors of renal insufficiency in patients with HF.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including 281 consecutive patients with HF that are examined at regular intervals at our outpatient clinic for HF. CKD was defined as the presence of an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and worsening renal function (WRF) was defined as a decrease of eGFR > 15% within a year. We assessed the patient's medical history, laboratory and echocardiographic parameters at baseline and after 12 months.</p><p><strong>Results: </strong>Right ventricular dysfunction was associated with CKD and WRF. In particular, echocardiographic parameters 'tricuspid annular plane systolic excursion (TAPSE) < 15 mm' (P < 0.001; OR 2.932), 'tricuspid regurgitation (TR) > I°' [P < 0.001; odds ratio (OR) 5.958] and dilatation of inferior vena cava (IVC) (P < 0.001; OR 3.670) were significantly correlated with renal failure. N-terminal pro-B-type natriuretic peptide levels were significantly associated with CKD (P < 0.001; OR 6.109) and correlated with pressure and volume load of the right heart.</p><p><strong>Conclusions: </strong>The results of this work support the theory of right-sided cardiac backward failure, often accompanied by hypervolaemia, as a leading cause of HF-related renal failure. Right heart parameters, especially TR, TAPSE and IVC, are obtained easily by transthoracic echocardiography and can predict renal failure.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of incidence, prevalence and death of aortic stenosis and aortic insufficiency in a nationwide Korean study.","authors":"Shin Yi Jang, Sung-Ji Park, Eun Kyoung Kim, Seung Woo Park","doi":"10.1002/ehf2.15249","DOIUrl":"https://doi.org/10.1002/ehf2.15249","url":null,"abstract":"<p><strong>Aims: </strong>Few studies have examined the incidence, prevalence, survival rate and death risk for non-rheumatic and rheumatic aortic stenosis (AS; RAS), aortic insufficiency (AR; RAR) and aortic stenosis with insufficiency (ASAR; RASAR). This study aims to identify the epidemiology of AS, AR, ASAR, RAS, RAR and RASAR.</p><p><strong>Methods and results: </strong>Data were collected from newly diagnosed non-rheumatic and rheumatic aortic valve disorders (AVD, ICD-10: I35 and I06, n = 101 895, female: male = 6:4) including AS, AR, ASAR, RAS, RAR and RASAR, excluding congenital heart disease. The data were sourced from the National Health Insurance Service in Korea from 2006 through 2017. Among all AVD, AR had the highest distribution. More than 70% of AVD patients were age ≥ 60 years. The age-standardized incidence of non-rheumatic AVD remained stable over the decade while the age-standardized prevalence increased. Conversely, both the incidence and prevalence of rheumatic AVD decreased. The 10 year survival rates (SR) of AS (49.2%), ASAR (50.2%) and RAS (51.4%) were lower than those for AR (64.5%) and RAR (69.2%). The adjusted hazard ratio for AVD was higher in individuals who were older, male, had a lower income level, diabetes mellitus, myocardial infarction, heart failure, atrial fibrillation, stroke, chronic kidney disease or malignant neoplasms.</p><p><strong>Conclusions: </strong>Over 70% of AVD patients were age ≥ 60 years. The 10 year SR of AS, ASAR and RAS exhibited similar patterns, all of which were lower than the SR for other AVD. AVD portends a worse prognosis in older individuals, males, those with lower income levels and those with comorbidities.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}